Tymanskaja N. Structurally - geometrical and functional changes of the right ventricle, maintenance of Cystatin C and NT-pro-BNP for patients with heart failure of ischemic genesis and their prognostic value

The thesis is devoted to the study of features of the structurally - geometrical and functional changes of the right ventricle for patients with heart failure of ischemic genesis in connection with the changes of maintenance of markers of Cystatin C and NT-pro-BNP in the whey of blood, the creation of prognostic criterions of the unfavorable outcome of the chronic heart failure and the detection of the most important factors which have an influence on the indexes of the annual survive. It is proved in the work that the signs of the structurally - geometrical and functional changes of the right ventricle appear in the I functional class in a kind of dilatation of the right atricle and violation of diastole type of filling of right ventricle are progressing according to the growth of the functional class and are evolving depending on stage of chronic heart failure of ischemic genesis: the hypertrophy of the free side of right ventricle develops, the dilatation of the right atricle and ventricle is in progress, the systole function of the right ventricle is going down with the forming of the highly expressed pulmonary hypertension (at the II-B stage). It is proved, that the maintenance of Cystatin C and NT-pro-BNP in the whey of blood of patients with heart failure of ischemic genesis is rising depending on the functional class, and growing directly accorded with the stage of chronic heart failure. When the heart failure is absent or when it is the first stage (the I functional class) of the heart failure, there is no correlation relationship between the maintenance of Cystatin C and the maintenance of NT-pro-BNP. The increase of functional class of the heart failure is closely accompanied with the appearance of the correlation relationship between Cystatin C and NT-pro-BNP. It is determined certain increase of Cystatin C and NT-pro-BNP in the whey of blood of patients with chronic heart failure of ischemic genesis with the presence of the systolic dysfunction of the left ventricle, the hypertrophy of the left ventricle and raised intra myocardial pressure. Infringement of structure of diastolic filling of left ventricle is accompanied with authentic growth of maintenance of Сystatin С and NT-pro-BNP in the whey of blood